How much rates vary
Facilitymedian $282 · 10th to 90th $71 to $3,981Professionalmedian $132 · 10th to 90th $78 to $214
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $154.88 Median $1,995.26 Typical High $7,943.28 | Facility | None | $154.88 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $190.55 | Professional | None | $81.28 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $70.79 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $57.54 | $70.79 | $117.49 |
AmeriHealth Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | None | $141.25 | $223.87 | $223.87 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $131.83 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $128.82 | $131.83 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $213.80 | Professional | None | $61.66 | $114.82 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $275.42 | Professional | None | $91.20 | $181.97 | $275.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $2,290.87 | Facility | None | $169.82 | $323.59 | $2,290.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Independence Blue Cross Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Martin's Point Setting Facility Modifier None Typical Low $154.88 Median $1,819.70 Typical High $6,606.93 | Facility | None | $154.88 | $1,819.70 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $186.21 | Professional | None | $81.28 | $138.04 | $186.21 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $70.79 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $57.54 | $70.79 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $257.04 | Professional | None | $70.79 | $70.79 | $257.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $158.49 Typical High $295.12 | Facility | None | $75.86 | $158.49 | $295.12 |
UPMC Health Plan Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $158.49 | Professional | None | $75.86 | $114.82 | $158.49 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,348.96 | Facility | None | $77.62 | $158.49 | $1,348.96 |
United Setting Professional Modifier None Typical Low $77.62 Median $141.25 Typical High $229.09 | Professional | None | $77.62 | $141.25 | $229.09 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $51.29 Typical High $85.11 | Professional | 52 · Reduced service | $40.74 | $51.29 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.89 Typical High $33.88 | Professional | 53 · Discontinued | $16.22 | $20.89 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $75.86 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $75.86 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.47 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.13 | $10.47 | $16.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $51.29 Typical High $85.11 | Professional | 52 · Reduced service | $40.74 | $51.29 | $85.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.42 Typical High $33.88 | Professional | 53 · Discontinued | $16.22 | $20.42 | $33.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $75.86 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $75.86 | $125.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.14 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $25.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.23 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.13 | $10.23 | $16.98 |
Where Pennsylvania sits
The same service costs 4.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Pennsylvania· 35th of 51
$141
AK $407KY $91.20
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.